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Perspectives From Patients Using a Food Pantry in a Family Medicine Residency Clinic: A Qualitative Study 在全科住院医师诊所使用食品储藏室的患者的观点:定性研究
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-09 DOI: 10.22454/fammed.2024.613582
Lauren N. Schutz, Steven R. Brown
Background and Objectives: Food insecurity is common in patients receiving care in primary care offices. Some health systems and primary care offices provide food directly to food insecure patients. Our family medicine residency clinic started a food pantry to directly address this social determinant of health. We aimed to understand the reasons patients in primary care visited our food pantry and their impressions of food available directly in a primary care office.Methods: We conducted semistructured interviews with 21 patients obtaining food from our food pantry. We recorded and transcribed the interviews, and analyzed them with an editing organizing style to highlight noteworthy segments, recognize patterns, and understand important themes.Results: Patients reported numerous barriers to obtaining healthy food, including cost, transportation, and time. Life-changing events often led a patient to a food pantry, and patients often prioritized family members when addressing food insecurity. Food pantry users appreciated the convenience of obtaining food at a medical visit and felt supported by healthy food that aligned with a message received from their physician.Conclusions: Food insecure patients face many barriers to obtaining healthy food. A colocated food pantry in a primary care office helps address barriers, is convenient, and is appreciated by patients using the service.
背景和目标:在基层医疗机构接受治疗的患者中,食物无保障的情况很常见。一些医疗系统和初级保健诊所直接向食物无保障的患者提供食物。我们的家庭医学住院医师诊所设立了一个食品储藏室,以直接解决这一影响健康的社会因素。我们的目的是了解初级保健患者光顾食物储藏室的原因,以及他们对初级保健诊所直接提供食物的印象:我们对 21 名从食物储藏室获取食物的患者进行了半结构化访谈。我们对访谈进行了记录和转录,并采用编辑整理的方式对访谈进行了分析,以突出值得注意的片段、识别模式并了解重要主题:结果:患者报告了获得健康食品的诸多障碍,包括费用、交通和时间。改变生活的事件通常会促使患者前往食物储藏室,患者在解决食物不安全问题时通常会优先考虑家庭成员。食品储藏室的使用者对在就诊时获得食品的便利性表示赞赏,并认为健康食品符合他们从医生那里获得的信息,从而为他们提供了支持:结论:食物无保障的患者在获取健康食品方面面临许多障碍。在初级保健诊所内设立食品储藏室有助于解决这些障碍,而且非常方便,使用该服务的患者对此表示赞赏。
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引用次数: 0
Health Equity: A Guide for Clinicians, Medical Educators & Healthcare Organizations 健康公平:临床医生、医学教育工作者和医疗机构指南
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-09 DOI: 10.22454/fammed.2024.871711
Kenneth W. Lin
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引用次数: 0
Generative Artificial Intelligence and Large Language Models in Primary Care Medical Education 初级医学教育中的生成人工智能和大型语言模型
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-08 DOI: 10.22454/fammed.2024.775525
D. J. Parente
Generative artificial intelligence and large language models are the continuation of a technological revolution in information processing that began with the invention of the transistor in 1947. These technologies, driven by transformer architectures for artificial neural networks, are poised to broadly influence society. It is already apparent that these technologies will be adapted to drive innovation in education. Medical education is a high-risk activity: Information that is incorrectly taught to a student may go unrecognized for years until a relevant clinical situation appears in which that error can lead to patient harm. In this article, I discuss the principal limitations to the use of generative artificial intelligence in medical education—hallucination, bias, cost, and security—and suggest some approaches to confronting these problems. Additionally, I identify the potential applications of generative artificial intelligence to medical education, including personalized instruction, simulation, feedback, evaluation, augmentation of qualitative research, and performance of critical assessment of the existing scientific literature.
生成式人工智能和大型语言模型是信息处理技术革命的延续,这场革命始于 1947 年晶体管的发明。在人工神经网络变压器架构的推动下,这些技术将对社会产生广泛影响。显然,这些技术将被用于推动教育创新。医学教育是一项高风险活动:教给学生的错误信息可能多年都不会被发现,直到出现相关的临床情况,这种错误才可能导致对病人的伤害。在这篇文章中,我讨论了在医学教育中使用生成式人工智能的主要限制--诱导、偏见、成本和安全性,并提出了一些解决这些问题的方法。此外,我还指出了生成式人工智能在医学教育中的潜在应用,包括个性化教学、模拟、反馈、评估、定性研究的增强以及对现有科学文献进行批判性评估。
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引用次数: 0
Volunteering in Global Mental Health: A Practical Guide for Clinicians 全球心理健康志愿服务:临床医生实用指南
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-15 DOI: 10.22454/fammed.2024.715685
Tara Devaraj
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引用次数: 0
The Long War on Drugs 漫长的禁毒战争
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-15 DOI: 10.22454/fammed.2024.646967
Paul Lazar
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引用次数: 0
Climate Change and Public Health, Second Edition 气候变化与公共健康》,第二版
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-12 DOI: 10.22454/fammed.2024.920787
A. Gertz
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引用次数: 0
Pieces of Wood 木片
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-02 DOI: 10.22454/fammed.2024.843857
Magnolia Larson
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引用次数: 0
A Nation Turns Its Lonely Eyes to You. 一个民族将孤独的目光投向你。
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-01 DOI: 10.22454/FamMed.2024.151960
Joseph W Gravel
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引用次数: 0
Benefits and Risks of Using Social Media in Academic Medicine. 学术医学界使用社交媒体的益处与风险。
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-01 DOI: 10.22454/FamMed.2024.532147
Kenneth W Lin
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引用次数: 0
Effect of Student-Run Free Clinics on Family Medicine Match Rates: A Multisite, Regression Discontinuity Study. 学生开办的免费诊所对家庭医学匹配率的影响:多地点回归不连续研究》。
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-01 Epub Date: 2024-05-20 DOI: 10.22454/FamMed.2024.329555
Spencer Dunleavy, Heather L Paladine

Background and objectives: Student-run free clinics (SRFCs) have been proposed as one educational strategy to increase medical students' interest in primary care careers. We sought to overcome gaps in the literature by investigating the effect of opening an SRFC at different institutions on institution-level match rates into family medicine, the largest source of primary care physicians in the United States.

Methods: We connected a list of SRFCs from primary care clerkship directors and the Society of Student-Run Free Clinics with a database of institution-level match rates into family medicine from 2000 to 2018. Using regression discontinuity analysis, we assessed whether opening an SRFC would increase family medicine match rates.

Results: Across a sample of 58 medical schools in the United States, we found that SRFCs did not significantly change the number (P=.44) or percentage of medical graduates (P=.42) entering family medicine residency. We also found no significant effects of SRFCs on the number of students entering family medicine in different contexts, including public/private institutions (P=.47), geographic areas (P=.26), departmental administrative structures (P=.69), and institutions with higher historical rates of producing graduates entering family medicine (P=.22).

Conclusions: Though SRFCs may potentially support other aspects of undergraduate medical training, they should not be used as a singular strategy for addressing shortages in the primary care workforce in the United States. Further educational research should examine multipronged strategies to increase the supply of early-career primary care physicians in the United States.

背景和目标:学生开办的免费诊所(SRFC)被认为是提高医学生对全科职业兴趣的一种教育策略。我们试图通过调查在不同院校开设 SRFC 对院校级家庭医学匹配率的影响来填补文献空白,家庭医学是美国全科医生的最大来源:我们将初级保健实习主任和学生开办的免费诊所协会提供的 SRFC 名单与 2000 年至 2018 年全科医学的院校级匹配率数据库连接起来。通过回归不连续分析,我们评估了开设 SRFC 是否会提高家庭医学专业的匹配率:在美国 58 所医学院校的样本中,我们发现 SRFC 并未显著改变进入家庭医学住院医师培训的医学毕业生人数(P=.44)或比例(P=.42)。我们还发现,在不同情况下,包括公立/私立院校(P=.47)、地理区域(P=.26)、院系行政结构(P=.69)以及历史上培养出较多家庭医学毕业生的院校(P=.22),SRFC 对进入家庭医学专业的学生人数没有明显影响:虽然 SRFCs 有可能支持本科医学培训的其他方面,但不应将其作为解决美国初级医疗人才短缺问题的单一策略。进一步的教育研究应考察多管齐下的策略,以增加美国早期初级保健医生的供应。
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引用次数: 0
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Family Medicine
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